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Emphysematous pyelonephritis in a renal transplant recipient – Is it possible to salvage the graft?

Venkatramani Vivek, Arabind Panda, Antony Devasia

Ann Transplant 2012; 17(3): 138-141

DOI: 10.12659/AOT.883469

Available online: 2012-09-26

Published: 2012-09-26

Background:    Emphysematous pyelonephritis (EPN) is a rare but potentially devastating complication after renal transplantation. It carries the risk of graft loss and is associated with a high mortality. The majority of cases reported thus far have undergone graft nephrectomy.
    Case Report:    We report the case of a live-related renal transplant recipient who presented 10 years later with fever, graft tenderness and worsening serum creatinine. Computed tomography (CT) revealed emphysematous pyelonephritis, with a large perinephric collection. The case was managed successfully by percutaneous drainage.
    Conclusions:    Percutaneous drainage is a safe and effective therapeutic modality in cases of EPN in transplant recipients, and allows salvage of the renal allograft in most cases.

Keywords: emphysematous pyelonephritis, transplant, percutaneous drainage